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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2265 - 18 February 2019 Posted By: Limin Yu

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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79M, history of T-cell rich B-cell lymphoma who had 2 cyascles of R-CHOP. Admitted with neutrophilic fever. Multiple skin lesions on right calf, neck, back. The lesions are bleeding with central necrosis


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Krishnakumar subramanian

Posted

sweat gland necrosis with mixed acute inflammatory cells

NEH

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Krishnakumar subramanian

Posted

since NEH  is seen post AML chemotherapy, if this is happening in post R-CHOP protocol, must we exclude infections also in this patient, please sir later let me know

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Chemotherapy-associated TEN and necrotic neutrophilic hidradenitis.

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Dr. Mona Abdel-Halim

Posted

I think there is vasculopathic changes (could be DIC) and ? herpetic folliculitis? 

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Krishnakumar subramanian

Posted

yes prominent endothelial cells are seen with inclusions like, could it be Herpes/CMV endothelitis with secondary eccrine changes

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Alex-Ventura-Leon

Posted

I see vasculopathic changes and prominent necrosis of the epidermis and folicullar epithelium. Also some kind of viral cytopathic changes in the later. Difficult but herpes its a good possibility.

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Dr. Richard Carr

Posted

Agree consistent with disseminated herpes/VZV.

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